The Organization of American States established the Court in 1979 to enforce and interpret the provisions of the American Convention on Human Rights. Its two main functions are thus adjudicatory and advisory. Under the former, it hears and rules on the specific cases of human rights violations referred to it. Under the latter, it issues opinions on matters of legal interpretation brought to its attention by other OAS bodies or member states.

The adjudicatory function requires the Court to rule on cases brought before it in which a state party to the Convention, and thus has accepted its jurisdiction, is accused of a human rights violation.

Trinidad and Tobago originally signed the Convention on 28 May 1991 but suspended its ratification on 26 May 1998 (effective 26 May 1999) over the death penalty issue. In 1999, under PresidentAlberto Fujimori, Peru announced it was withdrawing its acceptance of the Court's jurisdiction. This decision was reversed by the transitional government of Valentín Paniagua in 2001.

In the written phase, the case application is filed, indicating the facts of the case, the plaintiffs, the evidence and witnesses the applicant plans to present at trial, and the claims for redress and costs. If the application is ruled admissible by the Court's secretary, notice thereof is served on the judges, the state or the Commission (depending on who lodged the application), the victims or their next-of-kin, the other member states, and OAS headquarters.

For 30 days following notification, any of the parties in the case may submit a brief containing preliminary objections to the application. If it deems necessary, the Court can convene a hearing to deal with the preliminary objections. Otherwise, in the interests of procedural economy, it can deal with the parties' preliminary objections and the merits of the case at the same hearing.

Within 60 days following notification, the respondent must supply a written answer to the application, stating whether it accepts or disputes the facts and claims it contains.

Once this answer has been submitted, any of the parties in the case may request the Court president's permission to lodge additional pleadings prior to the commencement of the oral phase.

The president sets the date for the start of oral proceedings, for which the Court is considered quorate with the presence of five judges.

During the oral phase, the judges may ask any question they see fit of any of the persons appearing before them. Witnesses, expert witnesses, and other persons admitted to the proceedings may, at the president's discretion, be questioned by the representatives of the Commission or the state, or by the victims, their next-of-kin, or their agents, as applicable. The president is permitted to rule on the relevance of questions asked and to excuse the person asked the question from replying, unless overruled by the Court.

After hearing the witnesses and experts and analyzing the evidence presented, the Court issues its judgment. Its deliberations are conducted in private and, once the judgment has been adopted, it is notified to all the parties involved. If the merits judgment does not cover the applicable reparations for the case, they must be determined at a separate hearing or through some other procedure as decided on by the Court.

The reparations the Court orders can be both monetary and nonmonetary in nature. The most direct form of redress are cash compensation payments extended to the victims or their next-of-kin. However, the state can also be required to grant benefits in kind, to offer public recognition of its responsibility, to take steps to prevent similar violations occurring in the future, and other forms of nonmonetary compensation.

For example, in its November 2001 judgment[2] in the Barrios Altos case – dealing with the massacre in Lima, Peru, of 15 people at the hands of the state-sponsored Colina Groupdeath squad in November 1991 – the Court ordered payments of US$175,000 for the four survivors and for the next-of-kin of the murdered victims and a payment of $250,000 for the family of one of the victims. It also required Peru:

to grant the victims' families free health care and various forms of educational support, including scholarships and supplies of school uniforms, equipment, and books;

to publicly apologize for the incident and to undertake to prevent similar events from recurring in the future;

and to erect a memorial monument to the victims of the massacre.

While the Court's decisions admit no appeal, parties can lodge requests for interpretation with the Court secretary within 90 days of judgment being issued. When possible, requests for interpretation are heard by the same panel of judges that ruled on the merits.

The Court's advisory function enables it to respond to consultations submitted by OAS agencies and member states regarding the interpretation of the Convention or other instruments governing human rights in the Americas; it also empowers it to give advice on domestic laws and proposed legislation, and to clarify whether or not they are compatible with the Convention's provisions. This advisory jurisdiction is available to all OAS member states, not only those that have ratified the Convention and accepted the Court's adjudicatory function. The Court's replies to these consultations are published separately from its contentious judgments, as advisory opinions.

The Court's behaviour has also been criticized. Among other issues, some authors have criticized the politization of the Court.[3] Some of the latest criticisms come from Peru [4] and Venezuela.[5] Up to now Trinidad and Tobago is the only State who has withdrawn from the system.[6] Peru tried to do so, but did not follow the appropriate procedure.[7] The last of these criticisms is directed against the Court's decision in the case of the Mapiripán Massacre declaring that some people were murdered with the consent of the Colombian state, many of whom were subsequently found alive.[8]

As stipulated by Chapter VIII of the Convention, the Court consists of seven judges of the highest moral authority from the Organization's member states. These judges are elected to six-year terms by the OAS General Assembly; each judge may be reelected for an additional six-year term.

Unlike the commissioners of the Inter-American Commission, judges are not required to recuse themselves from hearing cases involving their home countries; however no member state may have more than one representative judge serving on the Court at any time. In the event a member state is party to a case as a defendant does not have a representative judge sitting on the Court, the member state is entitled to appoint a judge to the court ad hoc for the case.

After the Convention came into force on 18 July 1978, the first election of judges took place on 22 May 1979. The new Court first convened on 29 June 1979 at the Organization of American States Headquarters in Washington, D.C., United States.